There have been a number of studies, reports, news articles and complaints about the affordable care act in recent times that have risen above partisan politics. A number of them I have written about fairly recently.
The law, passed in 2010, is soon to be six years old. In that time it has withstood legal and legislative challenges (some still ongoing) and yet it survives. With so much time passed, we can truly study and gage the impact of the law on people, insurance companies and businesses alike.
But we also have to realize there are a number of provisions (i.e. the individual mandate) that were not implemented until years after the act pasted. One such provision is the so called “Cadillac tax”. The Cadillac tax is a tax on higher end health plans. These are plans that normally CEOs and executives have and very generous in their offerings. The tax was a “pay for” on the affordable care act. It was never popular.
Against this provision is, of course, big business which are traditionally a Republican conservative interest group. But because of this tax it now include traditional democratic allies of President Obama like unions. In Friday’s Variety we learn Hollywood’s writers guild union have joined others in opposition to the tax. They have an ally in representative Joe Courtney a democrat who is trying to strip the bill of this tax. They assert:
“The Tax will undermine the intent of the ACA by making health care less affordable for our members and the millions of Americans with employer-provided health insurance by forcing benefit cuts and increasing out-of-pocket costs,” executive director David Young wrote in the letter. “It will further shift the burden of rising costs onto workers while failing to address the root causes.”
Speaking of interest groups – let’s not forget the Supreme Court has been through three and is now on its fourth challenge to the law (2012 – National Federation of Independent Business v. Sebelius, 2014 – Burwell v. Hobby Lobby Stores, 2015 –King v. Burwell). Currently on the docket is a case filed by religious organizations fighting the ACA. Lyle Dennison at SCOTUSBLOG reminds us:
“…in the final year of President Barack Obama’s term in the White House, the Supreme Court turns next to the plea of religious non-profit schools, colleges, hospitals and charities to be exempted from any role in carrying out the law’s promise of free contraceptives to working women and some students. It is a high-stakes sequel to the 2014 ruling giving some for-profit companies an exemption from that mandate, and it probably will further clarify church-state relationships in America.
Actually, the government has on its docket a fifth challenge to the act, but it has not yet agreed to review that case (Sissel v. Department of Health & Human Services). It involves a claim that all of the tax provisions in the act are unconstitutional because they did not originate in the House of Representatives, as the Constitution requires for revenue-raising legislation. When the Senate passed the act, it did so by substituting an entirely new text for a less important bill that did originate in the House. Lower courts have rejected that challenge. The Court may act on it early in the new year and, if it promptly granted review, that case, too, could be decided in the current Term.”
So what happens when interest groups from all sides begin picking apart the affordable care act? When supporters and detractors alike take aim? What happens when a law that was supposed to fundamentally change healthcare as we know it – make it affordable, insure everyone and not add to the deficit – slowly fails to achieve all of those things? Will it be forced to change to something better? Or will the enemies finally achieve their goals? And will all of this – all that has been lost for Democrats including losing the House for at least a decade – be all for naught? Time will tell.
No, the fight over the affordable care act is certainly not over. And its survival may not depend on who is in the White House.